Cancer is that the second leading reason of death globally after cardiovascular diseases. Patients with cancer generally have a poorer prognosis in low-income and middle-income countries, including India, thanks to relatively low cancer awareness, late diagnosis, and the lack of or inequitable access to affordable curative services than patients in high-income countries [1, 2]. Bronchogenic carcinoma was once wont to describe a selected form of cancer that arises within the bronchi (the large airways of the lungs) and bronchioles (the small branches into which the airways divide).

Today, it's considered another name for carcinoma generally. We check with tracheal, bronchus, and carcinoma as carcinoma during this report for simplicity. The number of incident carcinoma cases in India in 2016 was 67 000 (95% UI 63 000–72 000), 72•2% of which were in males, and therefore the prevalent cases were 74 000 (70 000–80 000). This cancer was the second most familiar incident cancer among males in 2016. The age-standardized incidence rate of carcinoma varied eight times in both sexes combined across the states of India in 2016. The crude carcinoma incidence rate in males was highest in Kerala and Mizoram, and in females was highest in Mizoram and Manipur.

There was a 6•3 times difference between the very best and lowest state-specific crude disability-adjusted life-years DALY rates for carcinoma in 2016. The crude DALY rate for carcinoma in 2016 was highest in Mizoram, followed by Kerala, Manipur, Jammu, and Kashmir. Carcinoma was the primary or second leading reason behind cancer deaths in 19 states for males and four for females in 2016. Tobacco use and pollution were the top risk factors within the Global Burden of Diseases (GBD) for carcinoma in India in 2016, to which 43•2% and 43•0% of the carcinoma DALYs might be attributed, respectively [3].

There is a lack in our current understanding of the changing epidemiological trends of carcinoma among Indian patients. While the worldwide trend of an increase in adenocarcinoma appears to be paralleled in India, we don't completely understand the alarming rise in carcinoma incidence among nonsmokers. We have, specifically, a limited understanding of the impact of the factors that are unique to our regions, like the presence of indoor pollution, the utilization of domestic or biomass fuel exposure, the presence or lack of micronutrients in

NSCLC, including epithelial cell carcinoma, adenocarcinoma (bronchoalveolar cell carcinoma), and enormous cell and anaplastic carcinoma (including giant- and clear-cell carcinomas). Patients included unresectable or inoperable stage III disease, including N2–N3 disease and any T stage, or those with T4 and nodal stages. Patients with N3 disease were eligible if all gross diseases could be encompassed within the radiation boost field. All patients had the measurable or assessable disease measured by chest radiography, CT, or MRI performed within 28 days of registration. Assessable lesions included ill-defined masses related to post-obstructive changes or mediastinal or hilar lymphadenopathy measurable only in one dimension. A radiation oncologist saw all patients before enrollment in the study. Additional eligibility criteria included a CALGB PS of 0–1, weight loss of two months.

5. Histologically or cytologically confirmed diagnosis of inoperable IIIA or IIIB NSCLC suitable for radical RT, WHO/ECOG PS 0–2, a measurable or evaluable neoplastic lesion in keeping with WHO criteria, adequate bone marrow.
6. Previously untreated initially unresectable (or inoperable for medical reasons) non-metastatic NSCLC (histologically or cytologically confirmed) without homolateral malignant pleural effusion and homolateral (except for upper lobe lesion) or hetero-lateral supraclavicular lymph gland involvement; no functional or anatomical contraindication to chest irradiation; an assessable or measurable lesion had to be present. Patients shouldn't have a previous history of malignancy except for non-melanoma skin carcinoma or in place carcinoma of the cervix and 'cured' neoplasm.

Exclusion criteria:

1. Postoperative thoracic recurrence or a history of any previous or concurrent cancer (except that of the skin) unless the patient had shown no evidence of disease for >5 years. Patients with malignant pleural effusion were also excluded.
2. Patients with pleural effusion or distant metastases weren't eligible. Patients were excluded if they'd had previous invasive malignant tumours aside from squamous or basal cell carcinoma of the skin within five years of randomization or previous RT or CTX.

This study may be a prospective and retrospective study. During this study, patients were investigated in systemic order include name, age, sex, legal status, occupation, address, and chief complaint.

Their complaints with duration were noted. Progression of symptoms from the onset, development of latest symptoms and treatment taken before if any, history of tuberculosis, chronic cough, smoking, and contact were recorded. The patient's vitals were recorded, and routine pathological investigation, including blood count, hemoglobin work, was tired all cases.

The specific procedure followed:-

• Radiological method
• Sputum
• Bronchoscopy

Biopsies: lymphoid tissue biopsy, accurate cut biopsy, and excisional Biopsy done.

Bronchogram/bronchography: The radiographic examination of the bronchial tree employing a positive contrast agent, which shows the bronchial branches as white shadows on an X-ray film. It required the introduction of dye into the bronchial tree followed by the radiograph, which outlines the cast of the bronchial tree on the chest radiograph. Bronchography gives valuable information about the control of bronchi and their abnormalities.

Two methods of Bronchography: Trans bronchoscopic and Direct bronchoscopic.
Direct Bronchoscopic:- Performed by Percutaneous trans tracheal technique, nasotracheal fine tube intubation, and injecting in laryngo pharynx using the curved cannula

Computed tomography: Performed for extent and precise location of mediastinal masses, small pulmonary lesions and extent of mediastinal lymphadenopathy, pathology of major vessels, and compression or displacement of esophagus.

Cytology: the target is to spot abnormal (malignant) cells, sheds within the tract and bronchial secretions.

Bronchoscopy: Bronchoscopy is a required method of investigation and in conjunction with radiology. It's the foremost helpful procedure concerning broncho pulmonary neoplasm. This can be meted out using either a rigid or flexible fiberoptic bronchoscope.

The maximum age group among the cases were 41-60, and male completely outnumbered the female (35 male and seven female).

Figure 1:Chest Radiograph showing sharply defined Ovoid mass in the dorsal segment of the right lower lobe.

Table 3: Presenting Symptoms in Bronchogenic Carcinoma

The most common symptom was Cough with expectoration in 33 cases (78.5%), followed by Haemoptysis and Dyspnea in 30 patients (71.4%). Fever was least common with 6 cases.

Medical Research are concerned with the recording of data on patients with cancer seen during a particular hospital. They are mainly used for reviewing clinical performance and, therefore, the hospital cancer program [5].

The incidence rates of Aizawl district were observed to be seven times and four times that of Osmanabad and Beed PBCRs in males and females, respectively. The best cancer incidence rate was observed within the Northeast region (6 PBCRs for males and 4 PBCRs for females) than other areas within the country. The leading sites of cancer within the NE region were nasopharynx, hypopharynx, oesophagus, stomach, liver, gallbladder, larynx, lung, breast, and porta. The NE region lacks the desired infrastructure for specialized treatment facilities, human resources, as seen by the low 5-year survival of breast, cervix, and head and neck cancer compared with the remainder of India. Many patients with cancer from the NE region are travelling outside the NE for treatment and cancer care [6, 7]. Local cultural factors and lifestyle choices may have contributed to the heterogeneity in cancer incidence patterns and differences in India, as was seen in Thailand [8].

Lung (9 PBCRs), mouth (9 PBCRs), oesophagus (5 PBCRs), stomach (4 PBCRs), and nasopharynx (1 PBCR) cancers were the foremost common cancers in men. Carcinoma was the leading site in metropolitan cities and the southern region, whereas mouth cancer was the top site within the West and Central regions. Carcinoma and oral/mouth cancer were the foremost common cancers among males within the Indian subcontinent [9]. There are cancers of several anatomic sites known to be related to tobacco utilization [10]. Supported PBCR data, almost one-third of the cancers were associated with the utilization of tobacco in India. India state-level disease burden initiative cancer collaborators estimated that tobacco use was the best contributing risk factor for cancer in India. In India,carcinoma is attributed to tobacco use and pollution, the leading risk factors [11].

As per the World Cancer Observatory, GLOBOCAN 2008 report, males predominate with a male: female ratio of 4.5:1, and this ratio varies with age and smoking status. The percentage increased progressively till 51–60 years so remained steady. Various reports have noted that the smoker: nonsmoker ratio is high at 20:1. After 40 years, the epithelial cell type was the foremost common in

Such diagnoses are related to the poorest outcomes. However, ;the explanations for this are likely to be complex. Doubtless, they include the more inferior performance status, more advanced disease, and greater levels of socio-economic deprivation of patients who present during this way [18]. The first-line investigation of suspected ;carcinoma remains the CXR. CXR has the advantage of being cheap and accessible [19], with an occasional radiation dose of 0.02 mSv like three days of natural background [20].

Unfortunately, CXR includes a significant false-negative rate, with roughly 75–80% [21-24]. One study has reported that 10% of the CXRs of carcinoma patients were initially reported as normal, with an extra 13% reported as abnormal but with no suspicion of carcinoma [21]. Despite its limitations, evidence suggests that strategies to extend CXR uptake can yield improvements in referral rates and possibly improve the early detection of lung cancer [25, 26].

Our study also proves the above statements because Out of 150 patients with intrathoracic lesions, 42 patients diagnosed for Bronchogenic carcinoma, a definitive diagnosis was confirmed by Clinical & Radiological (chest X-ray & CT Scan) in 24 (16%), by Bronchoscopic examination & Biopsy in 15 (10%) and by thoracotomy in 03(2%).

This study provides a framework for assessing the prevalence of bronchogenic carcinoma in the North Indian population. Evidence of the study concludes the occurrence of bronchogenic carcinoma among males with a habit of smoking for more than 18 years. Cough with expectoration followed by Haemoptysis and Dyspnea are primary clinical features among the diagnosed cases. Depending on the level of risk, strategies including safety netting, planning a repeat Chest X-Ray after an appropriate interval or an urgent referral for further investigation such as CT or secondary care assessment may be reasonable.

Outcome Of This Study

• Prevalence of Bronchogenic Carcinoma among all cases of Intrathoracic Lesions Cases (150) – 28 %
• Prevalence of Bronchogenic Carcinoma among all cases 1478 cases who undergone for screening in one year – 2.84%